Melanomas of the head and neck have high-local recurrence risk features and require tissue-rearranging reconstruction more commonly than basal cell carcinoma and squamous cell carcinoma: A comparison of indications for microscopic margin control prior to reconstruction in 13,664 tumors.
J Am Acad Dermatol
; 85(2): 409-418, 2021 08.
Article
en En
| MEDLINE
| ID: mdl-30458206
ABSTRACT
BACKGROUND:
On the basis of high-local recurrence risk features and tissue-rearranging reconstruction, consensus guidelines recommend microscopic margin control for keratinocyte carcinomas (KCs) but not for cutaneous melanoma.OBJECTIVE:
To compare high-local recurrence risk features and frequency of tissue-rearranging reconstruction for head and neck KC with those for melanoma.METHODS:
Retrospective cohort study of KC versus melanoma treated at the Hospital of the University of Pennsylvania with Mohs micrographic surgery.RESULTS:
A total of 12,189 KCs (8743 basal cell carcinomas and 3343 squamous cell carcinomas) and 1475 melanomas (1065 melanomas in situ and 410 invasive melanomas) were identified from a prospectively updated Mohs micrographic surgery database. Compared with KCs, melanomas were significantly more likely to have high-local recurrence risk features, including larger preoperative size (2.10 cm vs 1.30 cm [P < .0001]), recurrent status (5.08% vs 3.91% [P = .031]), and subclinical spread (31.73% vs 26.52% [P < .0001]). Tissue-rearranging reconstruction was significantly more common for melanoma than for KCs (44.68% vs 33.02% [P < .0001]; odds ratio, 1.98 [P < .0001]).LIMITATIONS:
This was a retrospective study, and it did not compare outcomes with those of other treatment methods, such as slow Mohs or conventional excision.CONCLUSION:
Melanomas of the head and neck have high-local recurrence risk features and require tissue-rearranging reconstruction more frequently than KCs do.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neoplasias Cutáneas
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Carcinoma Basocelular
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Carcinoma de Células Escamosas
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Cirugía de Mohs
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Márgenes de Escisión
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Neoplasias de Cabeza y Cuello
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Melanoma
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Recurrencia Local de Neoplasia
Tipo de estudio:
Etiology_studies
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Guideline
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Incidence_studies
/
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Female
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Humans
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Male
Idioma:
En
Revista:
J Am Acad Dermatol
Año:
2021
Tipo del documento:
Article